Assessment of the surgical outcomes of esotropia in pediatric subjects with high accommodative convergence/accommodation ratio: A clinical assessment

Background: Treating subjects with a high AC/A ratio and with esotropia is a challenging and complex procedure, often associated with increased near deviation which may lead to various outcomes following the surgery. Aims: The present study was conducted to assess outcomes following surgery in children with esotropia who were surgically treated with primary bilateral medial rectus (BMR) recessions. The study also compared preoperative and postoperative measurements in subjects with a high AC/A ratio to a normal AC/A ratio to assess surgical outcomes. Materials and Methods: 122 subjects were divided into 2 groups based on AC/A ratio into high AC/A ratio and normal AC/A ratio The subjects with high AC/A were treated with bifocal management if they had near persistent ET of ≥10Δ in full cycloplegic correction and not if they had far ET of ≥10Δ. Target angle at the time of the surgery was assessed with stereopsis presence via positive butterfly/fly, and near and distance deviations ≤10Δ within orthophoria. These success outcomes were compared in subjects with normal AC/A ratio and AC/A ratio groups. The collected data were subjected to statistical evaluation

Assessment of periosteal fixation of partial VRT and lateral rectus in subjects of exotropic duane retraction syndrome: A prospective clinical study

Owing to the ability of the lateral rectus to contract during adduction is regained, the surgical procedures only partly relieve the problem. Complete relief is seen only when the innervation to the lateral rectus, which is misdirected, is managed effectively. The present study was conducted to prospectively evaluate the efficacy of periosteal fixation of the lateral rectus muscle and periosteal fixation along with the partial VRT in subjects with Exo-DRS. 15 subjects with Exo-DRS were randomly divided into two groups, where Group I (n=7) subjects were treated with periosteal fixation of the lateral rectus muscle and Group II (n=8) subjects were treated using periosteal fixation of the lateral rectus muscle with split VRT. At 1 week, 1 month, and 3 months postoperatively, exophthalmometry, binocular single visual field, abduction and adduction range, and prism bar cover test was assessed. Adduction changed postoperatively from -1.7 to -0.5 in subjects of Group I and from -1.3 to -0.5 in subjects of Group II. TBSF (Total binocular single visual field) was 14.5 in subjects of Group I preoperatively and was 11.6 in subjects of Group II postoperatively. This change postoperatively was significant in both groups. In Group I.&nbsp